From split-screen lectures to instant-access podcasts, the internet offers an array of quick-hit CME solutions for the physician on the run.

You are a couple of weeks away from renewing your state medical license and you realize that you are 10 hours short on your CME requirement for the year. How are you going to cram in 10 hours of CME between your hectic schedule at work and home?  This month we’ll take a step away from gadget reviews and explore the many and varied ways you can use the internet to cram the requisite CME into your life.

While conferences are a great way to get large amounts of CME content, they are time-consuming and expensive. They require you to take time off from work and away from your family, often flying half-way across the country. Luckily, many great conferences offer their content online just a few weeks after the live event. In many ways, the post-conference material online is superior to the live experience. They often offer split video feeds with half the screen showing the slides and the other half showing the lecturer. Plus, you can easily “walk out” of uninteresting lectures – even skip a whole conference – without the fear of offending the lecturer. You can pause lectures at will and restart them when it’s more convenient. Try doing that next time you really have to pee in the middle of an ACEP lecture. “Umm, excuse me, Dr. Henry...would you mind holding that thought for a minute while I run to the bathroom?” Well, now you can pause, fast-forward, rewind, and even mute the lectures whenever you feel the urge. Web lectures also offer you the ability to watch only the content that you think is best suited to your needs. Online conference lectures are not without their drawbacks, of course. The content from the big lectures and courses are nearly always delayed some weeks, months, or even years, causing the lecture to lose some timeliness. More importantly, you lose the important interactivity of the in-person lecture. You can’t raise your hand to ask a question or catch the lecturer for a minute after they are done speaking.  There are some smaller education groups (mostly residencies) doing real-time streaming of their lectures, offering real-time remote education and the ability to ask questions, but this is by far the exception and a long way from being widely available.


Another good old-fashioned way to obtain CME is through snail mail.  Organizations such as EB Medicine offer you CME through monthly mailings.  You can choose from general emergency medicine, pediatric EM, and LLSA study guides.  These are chief-complaint oriented reviews of the literature with a series of questions to answer at the end.  There are similar offerings from ACEP with PEER VII board review questions, the monthly Critical Decisions in Emergency Medicine, and EM:Prep LLSA review materials. Monthly mailers are nice in that they allow a perpetual way for you to stay current with the literature while allowing you to choose the when and where for your CME. They lack some innovations of more modern CME sources as well as the social interaction of a week with your colleagues, but for the busy EP, they may be the only option. The internet is not reinventing this mail-in CME industry, but it’s certainly making content more accessible.  Access to online archives is included with many subscriptions allowing you CME from prior reviews. Plus, the internet gives you immediate access to this month’s reviews, which is great if you have unanticipated down time and forgot your mailer, or simply want to do the whole thing online.

For those who learn best by listening, audio CME has been an option at least since the invention of the cassette tape. If you have a long drive to and from work, audio CME can be a great way to consume medical information. I personally love to listen to CME audio during runs or when commuting on my bike (don’t worry, I only wear one earphone in my non-street-side ear). Some of the better sources for CME include Audio Digest, EM:Rap, and Emergency Medical Abstracts. Audio Digest takes current topics and serves up lectures around the topic of the month, while EM:Rap and Emergency Medical Abstracts discuss the current literature from multiple journals as it applies to emergency medicine. Most audio CME programs also come with some form of handout/mailer but the real magic lies in listening to the banter of talented speakers and commentators. In my opinion, audio has been the first to really flex the muscles of the internet – they allow immediate online access to the most recent audio material, no matter where you are in the world. Also, most programs grant you access to their audio archives, which means a world of content is only a short download away.

The obvious game-changing hardware to hit the scene for CME consumption has been the iPad. According to a recent study by Bulletin Healthcare, emergency physicians are second only to PAs in their usage of mobile devices. My iPad is small enough to go with me anywhere and can carry all of my PDF mailers and podcasts. I can use it to watch streaming or downloaded video content. But buyer beware. While the Apple iPad is the current runaway favorite media consumption device, it does not run Adobe Flash, which is the current heavy-weight media software. This is currently in flux as more developers use HTML5 for their online content, but I’d suggest that you ensure your content will play on the device you intend to buy before dropping several hundred dollars on hardware.

With all of the options listed above, the internet has become an excellent way to access CME from practically anywhere, anytime. My hope for the future is to take internet-based audio and video and make it more interactive through real-time online broadcasts. Of course, there is the fear that one day I will stand in front of an empty lecture hall while lecturing to thousands of EPs sitting at home in their underwear. As much as I like emerging technology, I still like to lecture to a flesh-and-blood, interactive audience.

Jason Wagner, MD, is an assistant professor of emergency medicine at Washington University in St. Louis.
Follow Jason on Twitter @TheTechDoc



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